God created man in the best calendar and in the best picture, and the wisdom to see what God take away the rights of one of those blessings or some little or too much. And the looting of one of these many blessings is in fact a kind of disability. And disabled is that man who robbed him function a vital organs in his body due to illness or injury, or hereditary, resulting in that it became unable to achieve their needs. Based on this, a disabled is not the person with a disability phenomenon such as blindness, deafness, lameness 000 and all but one of the diminution in the vitality of the human body.There are several types of disabilities such as hearing and visual disabilities, motor and sensory and mental health. And mental disabilities include cases of mental and behavioral disorders that the patient can not coexist with others is a natural as cases of schizophrenia and dementia, mental retardation cases of various levels 000 In this paper we will discuss the cases of mental retardation.

What is mental retardation:

Mental retardation is a state of lack of integration of the growth of brain cells or stop the growth of tissue from birth or in the early years of childhood because of what. And mental retardation is not a disease independent or appointed, but is a disease characterized by all decrease in the degree of intelligence of the child in relation to the rate of general intelligence, and the inability of in its ability to adapt.Intelligence .. The curve of intelligence:

Just a different concept of intelligence in his determined and psychologists and education, but it shows the "individual susceptibility to solve intellectual problems" or "its ability to adapt to new situations" or "its ability to think abstract and benefit from the experience." And intelligence in Alkromusat recipe inherited genes, but not limited to a single gene, but Gene is in the transactions and multiple small units that reason, the distribution of intelligence in the community to take pictures natural curve. This means that the average intelligence includes a majority of the population, while the ratio is less than the climb to the excellent intelligence and down to stupidity Valath.

And intelligence, which we understand that "mental ability" is subject to means testing and measurement psychological devised by reputable scientists and laid her foundations and methods of minutes called the "IQ tests" Intelligence Tests (including tests Terman - Merle, and Wexler). Can be considered the most accurate tests of intelligence reached modern psychology to determine if the human mind, even if it is not the ideal standards that do not leak out to the error.

IQ and IQ:

When it is said that the intelligence of the individual Doe "normal" Vnany he is normal (for) and compared to the IQ of the general population in that community at the same chronological age. Therefore, the mental age of the individual is the degree of intelligence compared to the actual general intelligence. It may be old in years less real or more.

And the person who is old mental than chronological age to be his intelligence is above average and vice versa. If the match was average construction and close to average.And IQ is the percentage between the ages of individual mental and chronological age.An individual who is 8 years old while the real degree of intelligence paralleled the age of four, the rate of intelligence 4 / 8 × 100 = 50

So IQ (IQ) = mental age / chronological age × 100The IQ ranges between 90-110 per capita average intelligence as a parameter, so that the low IQ below 80 is considered mentally retarded.

Toddler Category:

Classification toddler degrees of intelligence are as follows (depending on the classification of Terman):

IQ IQ

Genius 140 and above

Very clever 120-140

Zaki 110-120

Normal (average) 90-110

Marginal category 90-70

The definition of mental retardation:

Defines mental retardation as a lack of intelligence, which creates a lack of learning and adaptation with the environment that it begin before the age of eighteen years of age, and select the IQ (70) maximum for those mentally retarded and because most people who are at least average intelligence (70) The ability Adaptive limited and in need of care and protection, especially during the years of the study .. And select the age of eighteen because the clinical picture that occur after eighteen years of age called dementia (Alehtr) (Dementia).

Clinical pictures of mental retardation:

There are no specific physical features associated with mental retardation, but when it is part of the mental retardation to tuck satisfactory, the clinical features of these Allzimp will be present (such as physical features in to tuck Down).

And the following diagnostic indications cited by the U.S. DSM IV: -

Lack of job Alzkaiip clear for natural, so that IQ tests measured intelligence of an individual less than (70) and for young children and infants be observed is a clinical-Faisal.

Failure or defect in the adaptive functions of the person (ie, the effectiveness of the person's access to its expected for the year and the environment Cultural Rights), shows the imbalance in two of the skills the following: (communication, care of self, social interaction, direct self-defense, academic skills, work, safety).

Picture of one of the infected children with mental retardation and disability ...

Beginning before the age of 18 years.

Images and mental retardation of varying ability to social activity, motor and school, according to the degree of intelligence, therefore, divided into the following clinical types:

Low-grade mental retardation: (Mild Mental Retardation)

This type of up rate to about (80%) of the mentally retarded and have an IQ between (50) and (70) and are characterized by the growth of social skills, motor and verbal and approaching normal to the extent that it does not detect this type only in the primary school age when they need care in the early years Study first, then stumble and fail in her school years recent (ie, fourth, fifth and sixth primary), and when they grow up they may rely on themselves economically through the work does not require technical skill is high, but they need support and guidance when they are exposed to the difficulty they face in their lives.

This type of rate of about (12%) of the mentally retarded and is located intelligence of its members between (35) and (49) and learning the social skills, motor and verbal be weak before the age of primary school, but the training and supervision improve these skills somewhat especially with more advanced age, and they do not could bypass the second grade of primary school up there with the supervision and care and can be trained on some professional skills is complex, and when they grow up they can do the work does not require skill and in specific circumstances (ie without the complexity), under the supervision and guidance, and support.

Severe mental retardation division: (Severe Mental Retardation)

The percentage of this type (7%) of the mentally retarded and IQ of the members of this type between (20) and (34) and are characterized by impaired development of motor and verbal, which delayed their ability to talk to primary school age, and can be trained to control the Mforeighm not fit for school and get better at the age of adolescence, where they can do some very simple work tasks and under constant observation.

They are the most vulnerable human intelligence at all, and less mentally retarded in terms of IQ rate of IQ less than (20) Fortunately, they represent the lowest common among the mentally retarded, a (1%), and the distinctiveness of disability total in childhood, adolescence, and lack of growth of any of the motor skills, verbal, or social, as well as lack of control in the hydrothermal (urinate and defecate) may be able to learn some words in adult life, and disability due to complete this, it needs continuous assistance and care.

Non-specific mental retardation:

Used in cases of mental retardation is clear clinically, but can not be measured degree scales Intelligence inhalers, and this occurs in cases of non-cooperative and infants who can not measure intelligence or available measures intelligence suitable for them, and notes that it is difficult to diagnose mental retardation The smaller the child's age.

It is therefore clear how different is clinical mental retardation, who tells us in knowing what is predicted by a child's future, and what can we demand of it an achievement to academic or social or professional, without the share of child frustration and Nthmh fail, we will bear more than its capacity, then we impose by the types of punishment, psychological and physical , and this makes the child worse achievement and less adaptable and more miserable.

Factors affecting the intelligence:

The period of pregnancy and early childhood and adoption of kidney care, mother - and others - make it child's brain crude vulnerable to external factors, multiple and dynamic impact greatly on the extent of its development, and detection of mental inherited susceptibility. Just as intelligence is inherited in various capacities, it depends on the surrounding medium to clarify and exploit those qualities or to suppress.

Valzca So the outcome of the interaction of genetics with the ocean, may be difficult to determine the proportion of each. But the fact that should not be absent from the psychiatrist is that the factors surrounding the poor may sometimes lead to mental retardation.

Causes of mental retardation:

Of mental retardation for many reasons can be divided into two groups: primary (hereditary) and secondary (acquired).

The attributes are genetic male gametes in the female egg or before the moment of fertilization is determined by the ability and limits of intelligence potential. It is noted in this type of mental deficiency that exists in the history of the family the father or mother or both. The study examined the child and do not reveal the presence of any organic cause of acquired occurred after vaccination.

That infect a cell from the embryo after conception - ie after the established genetic traits, for reasons which are not inherited or passed on to other generations. The reason patients have multiple sources and formats such as: brain edema, and inflammation of the meninges and the brain, and psychological and social factors. And can be divided into those pathogens acquired in relation to stages of growth of the fetus and the child as a convenience to:

Factors within the uterus (pregnancy) Antenatal.Despite a number of research in the field of teratological except that 50% of congenital malformations is not known, and that 25% of the remaining percentage is due deformity defects chromosomal, and less than 10% due to environmental factors and the remainder to environmental factors and hereditary, and that there Many of the diagnostic methods that help to detect birth defects and these methods include intrauterine diagnosis.

As well as the diagnosis of distorting the child after birth, and that some cases be severe deformity is typically death of the fetus or the death of the child immediately after birth because of his inability to coexist with, or be as simple as a deformity in which adhesion of the Parties, or Down syndrome.

Photo of girl with shocking since birth ...

Risk

Known as Dr. Ekram Abdel Salam Professor of Pediatrics and Genetics, Faculty of Medicine, Cairo University, a deformed fetus as a fetus, who was alive at the time of the decision-making, but it differs from the embryo's natural presence of some congenital malformations simple or severe, whether these distortions visible external or internal, non-phenomenon .

These distortions may not be compatible with uterine life, and therefore would not be complete during pregnancy, or be compatible with uterine life only, but could not the child after birth, or be compatible with uterine life and life after birth.

In the first scenario ends pregnancy abortion self, during the first months of pregnancy and usually do not have a chance to intervene only if there is a danger to the mother's life, as in cases of ectopic pregnancy, and examples of the distortions severe, which include central nervous system and internal organs, or disruption of chromosomes.

The second possibility: the pregnancy ends with the birth of a child dies immediately after birth or after a period of simple, such as heart defects severe that reflect the circulatory system or lead to mixing of arterial blood with venous blood at a higher rate of 30% or atrophy of the alveoli of the lung, or atrophy of the kidneys or some poor ,,,,bolic diseases that lead to severe shortages in the percentage of sugar or an increase in the acidity of the blood or in some gases in the blood.

Food assimilation

Says Dr. Nagwa Abdel Meguid is Professor of Human Genetics and head of the research of children with special needs at the National Center for Research, The ,,,,bolic diseases are many and diverse, and clouds are rare, but collectively represent a health burden is not significant, and it is estimated that a child is born infected with one of the diseases of ,,,,bolism per 50 thousand the case of the birth of the child is alive, and this is almost equal to the prevalence of diabetes for children.

And 20% of the babies who show symptoms of poisoning in the blood with the causes of bacterial, they have a disease of ,,,,bolism, which are classified by type of food they can not digest it, or because of toxic substances that accumulate body or in some cases as a result of yeast that are incomplete.

And ,,,,bolic diseases is divided into three sections:

First: the diseases caused by cellular toxicity.

And second: diseases resulting from a shortage of energy production.

And third: The disease is usually a mixture of several types, and are diagnosed with ,,,,bolic diseases through a sample of skin or muscle, liver or placenta, or liquid Caminos of the fetus during pregnancy.

In the third possibility: for the birth of deformed children, the pregnancy ends with a child compatible with life, live a life closer to the natural or semi-natural, and in this probability range distortions between distortions simple enable the child to live a normal life, such as cleft lip or malformations of the Parties or fingers .

Or the lives of semi-natural, such as mental retardation simple childlike, Mongolian, or some diseases of the poor ,,,,bolism that lead to mental retardation and swelling in some internal organs such as liver and spleen, but improved partially with treatment, and many of these children can live in their small community, or defects severely affect thelife of the child can not mentally or physically normal.

Causes of distortion

Dr. Ikram explains that the causes of abnormalities of the fetus, on the whole is divided into three sections:

First: the genetic causes as a result of mutations in the genes, which inherits the fetus from the parents and grandparents, which are either prevalent any inherited by the fetus from a parent or recessive any inherited the fetus from both parents, and lead these mutations to disease is hereditary in the fetus Iorth thus to a next generation and causebirth defects and genetic phenomenon in the trunk or head or limbs, or other phenomenon, such as poor ,,,,bolic diseases.

And deficiency diseases enzymes genetic or disruption in the formation of hemoglobin, which leads to anemia, a hereditary or immune deficiency genetic or bone disease and muscle genetic, and varies the impact of mutations that occur in the genes according to their impact on the formation of proteins that control the genes, depending on the proportion of the imbalance in the function of these proteins or enzymes or hormones.

The second type of reasons that lead to deformity of the fetus, they are: environmental causes as a result of fetal exposure in various stages to external influences experienced by the pregnant mother and thus the fetus such as exposure to radiation or environmental contaminants or abuse alcohol or drugs, or cortisone or cigarettes or sedatives or some antibiotics or hormones, or some headache medications or take iodine in large quantities, or lack of certain vitamins in the diet of a pregnant woman.

The impact of these environmental factors, according to the type and concentration and age of the fetus at exposure and increased adverse effect in the periods of early pregnancy, where that environmental factors harmful to the death of cells in the body.

Or delay the division of time and thus delay and distortion in the formation of the members of the body's internal and external, or weakness in the circulatory nutrients to the fetus, or erosion and calcification of the cells with a variety of infections and the inability to compensate for damaged tissue in the fetus.

She adds that Dr. Ikram third kind of reasons that lead to this distortion are the causes of environmental and genetic impact of common and different depending on the proportion of genetic factors to environmental factors.

Can lead these multiple factors causes the slight difference between people such as height or blood pressure or genetic diseases and congenital malformations, and most of the distortions that fall under this causes such as cleft palate, and deformities of the neural tube and congenital heart defects, and diabetes, and some allergies.

Distorting effect of the child psychologically

According to Dr. Mohammed Ghanem Professor of Psychiatry at Ain Shams University: The discovery of the existence of a deformed child is causing a kind of anguish for the parents, whether this discovery at the stage of uterine life or in the external life, and this can be sadness is severe and continuing problem without control is a distress chronically for for family members.

The problem of anguish lead to many diseases Alnevsjsmip, especially with the existence of feelings of guilt towards the child to sense the parents they are the cause of the problem suffered by this child deformed, and is telling parents something their child is necessary because of their right to psychologically identify the magnitude of the problem and how to deal with it.

It should be parents to be the final decision to maintain the pregnancy or terminate it and in light of the advice of medical specialists such as gynecologists, obstetricians, psychiatrists, doctors, pediatrics and genetics, as well as the advice of scholars of religion and the law in some cases.

The mother is depressed

Adds Dr. Mohamed Ghanem said the abortion of the child deformed, causing many psychological problems especially for the mother, such as infection by a state of sorrow and grief for the loss of a dear, and self-blame, for reasons real or imagined, especially in the case of the decision and regretting it, as well as a sense of parental helplessness before the problem can not solved, and the incidence of what is known as the duality of conscience where the conflict of ideas between acceptance and rejection, satisfaction and curses.

Can also be affected by the mother psychologically negative Vidfha grief to isolation from society and the inability to confront, as well as the fear of infertility, and in some cases, possible to be infected depression after an abortion, but it stops these reactions on the history of mental illness, and the desire for pregnancy , and the impact of abortion on the husband, and religious beliefs.

And then comes the role of psychiatry in solving the problem, by providing psychological counseling, and assistance in making the right decision, as well as attract the attention of relatives to support decision-makers, as well as strengthening psychological specialist after the decision not to regret it.

Abort the child distorting

As for the ethics of dealing with the child distorting "says Dr. Ikram: The ways of dealing with it vary depending on the severity of the deformity and the extent of its relevance to the lives of uterine or external and the impact of this distortion on the health of the mother and her life, if there is a risk, emphasizing the life of the mother, such as ectopic pregnancy or very high blood pressure her pregnancy or severe poisoning.

So we have a health, legal and legitimate to sacrifice the fetus to save the life of the mother, but if there is no risk to the mother's life The decision depends on the appropriateness of fetal life-uterine and external, in the case of the inadequacy of the fetus to life uterine such as the severe dislocation in Akarmozumat or birth defects severe heart or internal organs or lethal mutations in the genes.

These distortions and defects can be diagnosed either genetically engineered or not the growth of the fetus, or death within the uterus, and here we must get rid of the fetus methods sound medical and, if fetal abnormalities are consistent with uterine life and is compatible with the external life, in a certain defects such as severe in the neural tube, which lead to incomplete development of the brain or severe brain edema that leads to the death of the baby after birth.

Can not be with him that the delivery would naturally may be disposed of the fetus at the diagnostic and non-completion of the pregnancy, but in the case of distortions compatible with uterine life, as well as with external life, such as distortions of the Parties or bones or minor defects in the heart or other internal organs, or even defects ,,,,bolism that lead to mental retardation is not permissible here abortion because the child will be tailored with external life.

And also because many of the cases of ,,,,bolic defects can be avoided or improved by the initiative of mental retardation treatment immediately after birth, and other emerging treatment of these diseases with scientific advances in this area.

Ruling on abortion

And had to be present the views of Islam in the abortion of the child deformed, where the view of Dr. Mohamed Raafat Professor of Comparative Jurisprudence, Faculty of Sharia and the law, that it is permissible abortion in certain cases is the case the mother's risk of death, even reached the embryo stage the soul is breathed, the one hundred and twenty days.

This is based on base pay greater of two evils Bodnahma, ie if we were in front of two things both of which lead to damage, we have a damage lighter to avoid the occurrence of the damage the most, may also be abortion in the case of fetal malformation if not up to the stage of the footsteps of the soul in it, and his arrival to 120 days.

Therefore, they should conduct genetic testing before the link to the sponsors and introductions to the marriage, as well as the development of a pregnant woman since the beginning of pregnancy under medical care, and follow-up even if discovered deformation are trying to treat, or abort the fetus if the deformity is severe or does not accept treatment did not reach the age of 120 days, provided that be a distortion severely affects the child, can not live a normal life, or as close to normal mentally or functionally.

The distortions, the simple suit with life, and the child live with a normal life, such as cleft lip or malformations of the Parties or fingers or live a life of semi-natural, such as mental retardation and inflation in some internal organs, such as the liver and spleen, but improved partially with treatment, and all this did not up to 120 days, but it is not permissible to abort the fetus.

Diagnosis of intrauterine

Says Dr. Nagwa Abdel Meguid that can diagnose genetic diseases of the fetus in the womb, through the material produced by the fetal liver cells, gastrointestinal tract and urinary tract as well as secreted in the fetal amniotic water then seeps into the blood of a pregnant woman.

If the rose this article a lot in the blood of a pregnant woman during the fourth month of pregnancy may indicate the presence of twin pregnancy or the suffering of the fetus, such as disorder in the nervous system such as a fetus without a head or edema of the brain, or shows as well as the presence of disorder in the digestive system such as a lack of growth esophagus or duodenal, and also the presence of disturbances in the urinary tract, and various other disorders in the heart, and tumors Alasaos, but if the percentage of this article Vtkon serious indication of the incidence of Down syndrome.

To examine the fetus is also in the womb of his mother is enabled to make the abdominal wall and access to the fetus and Tnzirh where you can take a sample of liquid Caminos, who swam the fetus, and the best time being this test between the twelfth week and the sixteenth week of pregnancy, before the fetus grows to size significantly.

From this sample, which pulls can be the work of many of the medical tests such as trouble shooting chromosomal and the number of chromosomes in the cells of the embryo body, so no analysis of chromosomal, which is a laboratory test conducted to find out the number which is carried by the somatic cells of the chromosomes, as well as to detect any defects synthetic in construction .

There are a limited number of research centers in the world, which may enable diagnosis of the fetus with the disease, and that during the first weeks of pregnancy, and is by analyzing a sample of the wall Alkuriony surrounding the fetus in the tenth week of pregnancy, or cells from liquid Caminos in the sixteenth week of pregnancy, and measuring the rates of yeast responsible for the occurrence of the disease accurately.

Genetic diagnosis

The tests are also being carried out of the fetus: genetic diagnosis of the fetus (the gene) that causes the disease to spouses and children, and this is done by searching for the mutation causing the disease, and through which can tell whether the children were safe from the disease or who are carriers of the disease Kobuehm or not, and the doctor to conduct these tests at puberty, or when the intention to marry.

Taking what the person is a carrier of the disease, it requires examination last being a woman or a man who intends to marry her, but so far they do not have a thorough examination in only a few global centers.

Dr. Najwa shows that the safety of these tests does not necessarily mean that the person is free of the disease, because so many genetic diseases.

Also, many of these diseases are difficult to detect the absence of analysis of her or that the analysis is located can not discover the person carrying the disease accurately. Also, many of these diseases caused by defects in genes and that many of these genes, which up to about 30 A gene is not known has not been discovered, therefore, there is no analysis.

So for those applying for medical examination before marriage to know that medicine can not detect all diseases, and the applicant should investigate for each child or adult in the family and has a disease suspected to be congenital or genetically.

Reducing the percentage of deformity

Dr Jamal Abu pleasure Professor of Obstetrics and Gynecology Azhar: There are many ways in which we can reduce the incidence of fetal malformation, such as education to avoid inbreeding, especially if there was a date of birth of deformed children in the family.

And testing before marriage and to identify certain diseases that may lead to some congenital malformations in the fetus and the treatment of these diseases prior to pregnancy and childbirth, such as diabetes or take the necessary precautions to prevent their occurrence such as different blood type, and awareness not to delay the age at marriage or birth after the age of 35 years, where the increase the incidence of fetal malformation.

Also draw attention to a pregnant woman not to be subjected in the early months of pregnancy to x-rays, as well as not to deal with various drugs that may cause increased incidence of congenital malformations, and to convince a pregnant woman to take off from practices which may harm the fetus, such as drug abuse, smoking, alcohol and other harmful substances.